Gliederung

Objective

The gold standard of cervical disc surgery includes removal of the disc and fusion using an anterior approach. The loss of motion associated with fusion (PMMA or titanium cage) has prompted a search for other options. Experiences and results after implantation of disc prostheses allowing for biomechanical motion of helthy disc are evaluated in this study.

Methods

From may 2002 until Dec. 2004 88 prostheses were implanted in 87 patients (42 women,45 men in the age of 29 to 64 years). Follow-up experiences in patients clinical, radiological and neurological progress ranged up to 30 months. For the assessment of pain after surgery during the hospital stay a visual analogue scale was used. Patients were rated by the odom criterias to evaluate the clinical progress.

Results

The only significant complications were haemorrhages in two cases requiring surgical removal but otherwise uneventfull recovery. IN one case we noted an inadequate position of the implant, operative revision was required. No dislocation of the prostheses was noted in any patient after discharge from the hospital. Resolution of pain and neurological disorders were exellent and good in 73 patients (84%) with a general back to work rate of approximately 80% three months after surgery. X-ray follow-up after 3-7 days, 3 and 6 months after surgery showed an adequate range of motion of the inserted prosthesis ranging from 2 to 12 degrees (mean 5,4 degrees) in 75 out of 87 patients.

Conclusions

As the implantation of cervical disc prostheses carries no obvious risk higher than the risk of conventional anterior fusion, further analysis of its practicability and long term outcome is encouraged.